The Rare Conundrum…..

If I had a penny for every time my children have confounded the medical profession, I would as the saying goes, be a very rich lady.  I won’t dwell on the fact that if I had a penny for every time they have confounded me, I’d also be very rich…and probably less wrinkled, less dependant on caffeine (IV drip anyone?) Chocolate and wine but that’s another story.

However, let me elaborate why my precocious precious cherubs have elicited such responses as “we have never seen that before” or “that’s very unusual/odd/strange” and my personal favourite: “that just doesn’t happen!” – when confronted by my child doing exactly what doesn’t happen right in front of their eyes. 

You see my children, well 2 of them at least, are considered “rare.” On the whole I try to see that as a positive, albeit at times I think the whole world should appreciate their uniqueness by observing them inside a perspex case in a museum but usually those days are few and far between 😉

‘& here we have the lesser-spotted children horribles preserved for prosperity….’

2 years ago I wrote a blog piece to explain what being rare means and how it affects our family. If you would like to have a read: https://definitelynotthewaltons.com/2018/02/

Rare Disease Day is once again looming large upon us – 29th February 2020 to be exact. This year marks the 13th International Rare Disease Day which is held every year on the last day of February. 

Given that every 4 years the month of February inveigles an extra day into the calendar month and thus is a little bit quirky in itself, it seems especially fitting to celebrate all things rare in a unique month, highlighting the weird, wonderful and downright peculiar  (of the medical world you understand(!) – In fact this year there are reportedly 146 events in over 100 countries to raise  awareness on the day itself as well as  thousands of other events throughout February. You can learn more https://www.rarediseaseday.org/article/about-rare-disease-day

You may find yourself thinking that you don’t have anything in common with a rare disease or even know anyone affected by such a thing but if you will spare me a little more of your time, I’ll explain why in actuality, this misconception is most likely wrong.

Based on current data it is accepted that 1 in 20 of us will at some point in our lives be diagnosed with a rare disease and the majority of them, being so rare, will have no cure. Some of those rare diseases may be transient, others life changing and in the very worst cases, life limiting. 

It is not my intention to scare you or depress you (how am I doing so far?!) Merely to heighten awareness around the fact that rare diseases, well really they aren’t that rare and if you personally aren’t affected by one (or more) you are bound to know, possibly even be related to someone who is living with a disease or condition that falls under the rare moniker.

For those of you who are unfamiliar with my family background, I am a mother of 4 of the human child variety, married to the long-suffering Mr DNTW’s, owner (used in the very loosest of terms) of 2 crazy dogs and 1 cat. We used to have 2 cats but one couldn’t stand the melodrama of life with us and shipped himself out. Funnily enough he was also sort of rare, being of the ginger hue – ginger cats are apparently less common than the typical moggy; perhaps he just couldn’t face the competitive nature of this family in the rare stakes?

Furry friends

In a sense of irony that befits our family largesse, all our children have unique and/or rare genes and in a further twist of fate, we only discovered their ‘foibles’ for want of a better turn of phrase, in reverse age order!

I sometimes feel I have to add that bit in almost apologetically – the fact that we discovered this from youngest backwards I mean. When you exchange the usual pleasantries on meeting new people and the topic invariably comes round to the whats and wherefores of each other’s lives, they already think you are a bit bonkers because you have 4 children (or that you don’t have a TV – so, funny…ha, ha, ha….not!) Add in extra/special needs and they either assume you must have adopted and are therefore saintly or if they are your actual birth children, then you are clearly more than a bit soft in the head . Why would you go on to have 4 when you already have one or more with special needs?! Of course no one has been rude enough to say that to our faces (yet!) But you can feel the silent judgement all the same.

All the same, I will confess it was a bit of a poke in the eye with a sharp stick moment (understatement) when our then 17 year old (20 this year!! How?? Believe me I have asked myself this question a lot – I don’t feel old enough to have a 20 year old, although I definitely look and physically feel it) was diagnosed out of the blue with a congenital heart condition, solely as a result of a medical he had undergone because of his chosen career path.

Not only was this new diagnosis very scary – well to us as parents anyway, he took it with the brevity of teenagers and their immortality concept – I did have a bit of a why us moment? In fact I distinctly recall saying that in spite of us making beautiful, amazing and rather fabulous children, (offspring if you are reading this, don’t bother asking for a pocket money raise!) Mr DNTW’s and I are clearly a car-crash genetically.  

Considering there are approximately 7.8 billion people on earth, you have to wonder what the odds are that 2 people who are not related to each other in anyway other than by marriage (we have been asked by sooooooo many medical professionals over the year whether we are cousins/inter-family marriage and such like!)  manage to meet, marry and have kids, all of whom likely have extra needs all because of wonky DNA (technical term wonky!) from each parent; whose chromosomes whilst not an issue individually, in combination have resulted in the difficulties our children face.  There was a distinct wanting to rage against the unfairness of it all and a feeling of being given the shi**iest end of a really shi**y stick. It didn’t help that he received this news at a time I was also stuck in our local hospital with G-Man, (our 3rd) because of his own medical issues.

After a strong coffee (and probably wine) I gave my head a wobble and we began the medical process to discover more about his condition and the implications of it for his future. As these things go, if you have to have a heart condition, he has escaped relatively lightly. Whilst it is progressive in nature and will need addressing in the future, we already know that there are things that can be done when the need arises and because of our wondrous NHS, he will be reviewed regularly and receive the very best care and attention. 

According to an article produced by NHS England in 2016, congenital heart defects are the most common birth defect. Approximately 8 in 1000 children are born each year showing signs of disease and the figure rises still further to a prevalence of 4 per 1000 in adulthood – not quite sure why the discrepancy in figures. Perhaps because associated issues or co-morbidities of the disease are leading to an improved diagnosis ratio?   

Moving on. our almost 17 year old (another DNTW’s on the road later this year?? UK watch out!) is diagnosed with high-functioning autism, sensory processing disorder and traits of Pathological Demand Avoidance (PDA) 

Whilst it is right and proper that autism in his presentation is now more often referred to as autism spectrum CONDITION (previously stated as a disorder and within the medical/scholarly community, it largely remains so) it would be unfair to gloss over the difficulties that this diagnosis brings with it. 

Our son is many things: clever, bright, articulate on subjects he is passionate about (of which there are many) intensely focused on specific interests, able to recall events and facts from an astonishingly wide range of areas (and years of family memories, both a blessing and a curse!) and with a sense of humour that borders on cheek but *just* manages to avoid rudeness….most of the time. Sometimes I don’t know whether to laugh or wish I could gaffer tape his mouth shut; usually depends on the audience. 

But over the years, it has been hard to not understand each others perspectives. At times it’s  felt as if we were each speaking a foreign language with no hope of translation or commonality. It’s been scary and worrying and frustrating. 

Autistic people can find social interactions and communication in general problematic. There are so many surprising ways that we interact with each other so interpreting body language, tone of voice, facial expressions and even the spoken word can lead to a whole host of misunderstandings and anxieties which have knock on effects on self esteem, mental health and well-being.  

To witness his struggle to make sense of this world, to comprehend that the things we say are not always literal – only years later can we laugh about our miscommunications: the expression I used to use when in a rush to get out of the house in the mornings for school: “C’mon, get a wriggle on!” shouted in exasperation and then looks of disbelief at the child appearing to body-pop across the kitchen, which resulted in more shouting (not my finest hour). Or the look of horror on his face when I would say things like “Keep your eyes peeled” if I was looking for a car-parking space. 

Sensory difficulties in so many aspects of life too have taken their toll. Going out to eat at a restaurant, going shopping, holidays, day trips and even visits to family and friends require meticulous planning and contingencies. 

The intensity of the world around you when you are over stimulated by your senses  – hypersensitivity –  and your ability to regulate them must be extremely stressful for many autistic people and especially those with sensory processing difficulties. 

There is an excellent video courtesy of the National Autistic Society which demonstrates this very well: (be warned before viewing, this could be triggering for some people)   https://www.youtube.com/watch?time_continue=12&v=Lr4_dOorquQ&feature=emb_logo which my son tells me is very representative of how he feels when out in public. I know the first time I watched this I felt thoroughly over-whelmed and exhausted, craving peace and solitude by the end. School teachers I imagine this is a but a snap-shot of your day – kudos to you all.

Paradoxically people with sensory processing difficulties also experience significant hyposensitivity – under stimulation in certain senses, particularly tactile (touch) vestibularly (part of the brain/inner ear concerned with balance and eye movement) as well as proprioception  – awareness of one’s own body in space around you. These intertwined sensory needs can result in a craving for input in order for the person to self-regulate. 

These are all issues we have learned about and try to continually learn from in the best ways to support our son but it’s not an exact science.

So is autism a rare condition or one that’s being bandied about like a box chocolates? Hmnnnn, that’s difficult to answer. Certainly I have heard time and again that “autism didn’t exist in my day” more times than I care to recall. There’s a great meme, something along the lines of:

There was no autism diagnosed before 1830……

Mount Everest wasn’t ‘discovered’ until 1856 but I suspect it was there all along!

Our son didn’t receive his diagnosis until he was 10 and this isn’t unusual, even though we had first sought help and guidance when he was around 3 years old. Adults are increasingly being diagnosed later in life but diagnosis rates still vary hugely across the UK alone and there is no one specific test that can confirm whether an individual is autistic.  

In our wider family, there are a number of children with a confirmed diagnoses of autism and/or co-morbidities thereof. Whilst there may be a genetic component for some, testing may only indicate the presence of a known autism gene rather than whether the individual themselves is autistic. Genetics is advancing and evolving rapidly but there remains a long way to go. 

I personally believe the exact cause of autism is irrelevant and understanding, management and appropriate support should always be the best practice approach.  

So far, so not particularly rare or unusual you are probably thinking. However, where things get a little more complex is with our youngest 2 children, G-Man 13, and Minx 11. They may be the youngest but are truly determined not to be left out and are the 2 largely responsible for causing the medical community much vexation. For the time being we know that Minx has an as yet, undiagnosed neuromuscular condition, likely genetic in origin and it is likely that G-Man has a variant of this too.

Minx is the more severely affected but both children are tube fed, had severe reflux as babies, both have dysfunctional swallows related to muscle fatigue of repetitive action and there are various commonalities in their difficulties. 

This is what just 2 weeks of tube feeding equipment/nutritional supplement looks like….. for 1 child!! 🤦🏽‍♀️

Both children are SWANS. This is not a diagnosis. It stands for Syndromes Without a Name and you can learn more here: .https://www.undiagnosed.org.uk SWAN UK is the only designated support group for children and families in the UK without a diagnosis and they have provided my family with a life-line, connecting us with other families in similar situations, even though their children’s needs may be very different to my own. It has given us a sense of belonging, people to talk to at all hours of the day and night, balloons after hospital stays, coffee mornings and family days out. I know from my own experience and talking to others how valuable this is in our rare and undiagnosed community.

Thank you SWAN UK for balloons!

In the early weeks after Minx’s birth her difficulties came to ahead at the age of 9 weeks resulting in an emergency hospital admission and a flurry of subsequent appointments. None of them gave   answers.

I felt very alone and I pinned all our hopes on every specialist or therapist we encountered. I was convinced for at least the first 3 years of her life that the next appointment or admission would be the one where we got ANSWERS and  a PLAN. 

But despite being on genetic studies from the age of 6 months, enrolling on DDD – Deciphering Development Disorders: https://www.ddduk.org in 2013 and https://www.genomicsengland.co.uk/about-genomics-england/the-100000-genomes-project/ in 2015, at the age of 11 ,we still have no over-riding genetic answers.

I can reel you off a list of conditions: upper limb arthrogryposis, lower limb hyper-mobility, gastrointestinal reflux disorder, gastrointestinal dysmotility, chronic abdominal pain, muscle weakness and fatigue, congenital myopathy, etc etc  – but although we have seen specialist consultants in numerous different fields, at many different hospitals and although many differential diagnoses have been proffered, thus far nothing explains why my children require a feeding tube for nourishment, why Minx is a part time wheelchair user, has had to undergo countless operations, tests and procedures over her tender years. Why I can’t explain (to her immense frustration) why she is able to do something one minute but not the next; why she can be running around like her friends and then her legs turn to noodles and she can barely stand, let alone walk;  why her hands can hold a pen and write one day but the next it is all she can do to hold her head up; why the things so many of us take for granted are such a battle for her.  

I’ve held her in my arms as a baby, screaming as she was prodded and poked, as Doctors trooped in and out, relentless personal questions about whether my husband is my cousin or other close relative,  examining this body part and that – hers and mine!  X-rays, MRI’s, needles, blood tests, skin biopsies, muscle biopsies. 

I’ve handed her over to anaesthetists, surgeons or gastroenterologists more times than I can recall, laughed about her antics and singing (caterwauling?!) over pre-meds (an early indication of what she might be like when intoxicated in later years I suspect) manipulated her joints for intensive physiotherapy, tried different diets and multiple medications.   Soothed her, cajoled her, bribed her (she is VERY good at extortion!!) wanted to yell at her for being non-compliant but secretly proud of her feistiness and determination that has got her this far. 

G-Man too has had more than his fair share of tests, procedures, trials and tribulations. Both kids have been through more in their young years than many adults do in a life-time.

I’ve paced hospital corridors, driven in a state of recklessness when I should have called an ambulance, ridden in the back of them on blue lights, cried, put a brave face on, been meek when I should have called out poor practice and learnt to fight my children’s corner when necessary. 

I will always have respect for those in the medical profession but equally I no longer place them on a pedestal or assume they know best. They know their speciality, they don’t know my child/ren. It sounds a bit cliched and twee but I have learned such a lot over the years and I do consider it a journey of sorts.

These days I don’t often dwell on the fact that we don’t have a diagnosis and I try not to worry about what the future may bring. Other than typical parental worries: will they drive me to distraction by refusing to wear a coat even though it’s minus 2 with a windchill of minus 10 and snowing? HOW SHORT are those SHORTS?! Will she stop stealing my lipsticks, will he ever hang up his towel instead of leaving it on the bedroom floor,; will they do well in their exams (not because it matters to me as such, more that it opens doors for them),will they have a nice group of friends, make only the kind of mistakes they can learn from without devastating consequences? 

But sometimes in the small hours, or when something new rears it’s ugly head or when they ask me questions I can’t answer, those worries can’t be so easily silenced. And the truth is we don’t know what the future holds. I can waste time worrying about the ifs and buts and maybe’s but down that path lies only doubt and pain and I wont give it headspace.

Tomorrow is never a given for any of us so we may may as well make the most of today ❣️

Once Upon a Time….

IMG_0186Let me tell you a story. Are you sitting comfortable? Then I’ll begin…

Once upon a time there was a (relatively) normal family. Let’s call them the Jones’s, although I don’t think may people will be aiming to “keep up with the Jones’s”  once they have read this. In fact perhaps, it’s more a nightmare, horror type story rather than a settle-you-off-to-sleep bed time type of thing?

So the Jones’s live in a lovely but ordinary house in an ordinary part of the world and are distinctly unremarkable. Perhaps they break slightly away from the norm in that instead of the requisite 2.4 children per family, they have 4 (these days I hear that 3 is the new 2.4 anyway).

Not only do they have 4 children of varying ages but they in fact have 3 with special needs. In spite of some trials and tribulations along the way and more than a few bumps in the road over recent years, the Jones family are a happy bunch, very grateful for what they have and definitely appreciative of all the best things in life. They closely adhere to my own motto: the glass is half full – therefore more room for wine!

Nonetheless, at times things have been a bit sticky and the Jones family have often wondered whether they accidentally broke a lot of mirrors, spilt salt or walked under too many ladders for the gods of luck and chance to ignore. Perhaps they had poked the evil eye with a very sharp stick?!

When you have one child with a medical/phsyical or cognitive difficulties it can be tricky for the whole family. Add in 3, top that with children who don’t fit nicely into a tick box, one size fits all diagnosis, it becomes like doing a rubix cube – & Mrs Jones would freely admit that the only way she ever successfully completed one of those was by peeling the stickers off and rearranging them to fit the colour order…

However, the Jones’s have an extra dirty little secret;  it shouldn’t be such a stigma but it still is, even in this day and age:  one of their children has a significant mental health issue triggered by his diagnosis of autism spectrum disorder (ASD)  – aspergers with sensory processing disorder.

Since Christmas last year, the Jones have witnessed a steady decline in their son’s mental health. He has become increasingly unhappy, rebellious, not eating or sleeping well, absenting from class, leaving home, even jumping off the first floor roof in the middle of the night and self harming frequently. The Jones’s have had to call the police on more than one occasion to enlist their help in finding their son and getting him safely home.

The Jones’s suspect that the combination of puberty, hormones and aspergers plus main stream secondary school education is over-whelming for their son. School, to their credit, have been on board and supportive, despite what must be a very frustrating and difficult time for them too, especially considering the sheer volume of pupils in the school. The Jones boy –  we’ll call him James – has a cracking sense of humour when on top form but can be exhausting in the extreme, demanding of time, attention and support, and exhibit behaviour not dissimilar to that of a tantrum-ing toddler, only with a much more inventive vocabulary!!

One of the problems with a main stream school is that unless the teachers themselves decide to read up in their “free” time on subjects like autism, they will have had the very bare minimum input and training for special needs children. In spite of the huge rise in cases of autism being diagnosed, trainee teachers are given a mere glance at the SEN world and may encounter their first autistic child when he/she presents in the classroom as disruptive, disobedient, likely  in their mind set, a right little sh*t, a product of questionable parenting. You might want to take a look at the vey interesting article: http://www.autism.org.uk/get-involved/media-centre/news/2016-03-21-teacher-training.aspx

Anyone who has dealt with a high functioning autistic adult or child will be familiar with the rigidity of mind set and literal thinking that encapsulates ASD. Over the years Mrs J has been on the brunt of many a sharply retorted, brusk response that wasn’t quite in keeping with her expectations. She has learned not to use phrases such as “Would you like to help me unload the dishwasher/tidy your room etc?” She will be met with a re-sounding “NO!!”

To neuro-typical persons, (as those with aspergers or aspies like to call us) this response is cheeky, rude and impudent in the extreme;  que explosion from Mrs J, meltdown from James and all hell breaking loose Chez Jones. In the world of ASD however, Mrs J has merely worded the question wrongly and it’s taken quite a long time for her and the rest of the family to adjust their ways and rethink what they are ultimately trying to achieve.

If Mrs J was to turn to her son and phrase her request in a far less excruciatingly polite British fashion “Please can you help me unload the dishwasher,” she might have been met with a grumble or two but ultimately, James’s reply would generally have been far more acquiescent. You see, those with ASD hear the word “LIKE” in the request and assume it literally and therefore that they have an option in the matter. When you are cognisant of how important your phrasing is, you will realise those with ASD are merely being honest in telling you, no they would NOT LIKE to do the aforementioned chores.

It is perhaps something James’s maths teacher could have done well to remember. James came home from school only recently telling his parents he no longer needed to attend maths classes and what great news this was! Suspecting that somewhere along the lines, things might have been lost in translation, Mr and Mrs Jones quizzed him further.

It turns out that James’s maths teacher had told him, he didn’t care whether or not James attended his lesson since it was ultimately wasting his own time and the teacher would teach the rest of the class come what may. Not quite the you don’t need to come any more that James interpreted.

Similarly,  the cookery teacher having told James to bring in ingredients to make a sandwich that he would eat. Since James doesn’t eat sandwiches in any shape or form, he was not to be persuaded that he needed to take in balanced portions of protein, carbs, etc etc. In his view, he didn’t need to take in anything and it didn’t apply to him. Mrs Jones tried to reason with him and explain what the teacher had really meant but James had clearly heard the teachers instruction and was not to be dissuaded. James’s sense of injustice at the detention that followed was magnitude and I can’t say I blame him really.

Of course it goes without saying that meeting one person with autism doesn’t mean you have met them all; very far from it but there are key, recognised difficulties that cause a variety of difficulties for those with such a diagnosis.  Although those of us who are neurotypical can struggle to understand and see things from the point of view of someone on the spectrum, imagine how much more difficult it must be to live in a world that favours the neurotypical? Since ASD is a social communication disorder, body language, facial expressions, tones of voice, nuances and social niceties are things that often go over the heads of those individuals with aspergers and the like.

Additionally, sensory issues are extremely common for those on the spectrum. Noise, colours, lights, the environment, textures, tastes and smells can all be much more vivid or paradoxically dimmed necessitating those experiencing difficulties to crave further or seek to repress the influx and assaults on their sense.

James needs high and intense stimulation in most areas. He has always liked to push himself to extremes. Many a time the rest of the Jones family have looked on in horror as James scuttles up the nearest tree, climbing to the highest, most unstable branch, calling triumphantly from the top.

The faster, higher more exhilarating the roller coaster, the more James wants to ride it. Which likely explains why in younger years Mrs Jones found herself riding, unaccompanied, the most vomit inducing rides known to man. James having queued only to be disappointed and turned away from the ride due to his lack of height would beg and plead a reluctant parent to go on his behalf and feed back on the ride experience. Mr Jones would sensibly plead a bad back and leave Mrs J to take one for the team as it were….

In the winter James likes to sleep with PJ’s, a onesie, fluffy slipper socks, woolly hat and cocooned in  the highest tog duvet that can be found. Squished in like a sausage roll, surrounded by teddies and all things fluffy is his happy place. Little changes in the summer and it’s rare to see James without his trade mark hoody, firmly pulled over his head. Shorts are greeted with a look of disgust even if the fickle British summer busts the 30 degrees C mark (that’s 86 F my US friends.)

Noise is a problem. On his terms, James loves his music loud and pulsating. The Jones house reverberates with Back In Black and similar on a regular basis but James cannot tolerate his younger siblings playing or crying. Noises like the water heater springing to life, the background hum of a restaurant or kitchens in the distance, seem physically painful to him.

As for food. Mrs Jones will roll her eyes at you and clutch her hands to her head woebegone. It is a well known fact that children can be notoriously fussy but it is well documented that those with ASD find food particularly challenging. It presents numerous sensory issues – from texture, shape, size and smell. James can’t sit at a table with cheese, his food can’t touch any other item on a plate, his toast – plain, no topping, cannot be cut in half with a knife that has so much as touched anything else and the thing that was his most favourite thing EVER, that Mrs J bulk bought in a fit of jubilation will be consigned to the back of the cupboard only days later with rallying shrieks of disgust and a hearty “I HAVE NEVER EATEN THAT SO WHY DID YOU BUY IT!!!!” tirade. Unless of course it’s tomato ketchup, in which case, only the most expensive brand that will do, splodged liberally over everything and anything….it may be that Mrs Jones has found that a certain supermarket rhyming with ‘piddle’ do a brand that is just as good and as long as she decants  it in to the pricier named brand bottle without anyone seeing, nobody knows, but that would be telling.

So where does this leave the Jones family right now? Well they remain on quite a learning curve since their son was only formally diagnosed 3 years ago despite frequent presentations from the age of 4 to the Gp, Health visitor and eventually a CAMHS (Children and adolescent mental health) referral  requesting help, detailing their son’s extreme behaviours, anger, aggression, rigidity of thinking. It took from the age of 4 to almost 11 to get the diagnosis despite what in hindsight appear to be a glaringly obvious, one could say neon sign pointing to ASD.

Whilst the Jones’s would agree that labelling a child unnecessarily is never a good thing, it left them wondering in the wilderness feeling like terrible parents for far too many years. It dented their confidence and self belief and did unquestionable damage to their other children who were both witness and victim of their siblings extreme behaviours.

And yet, even now, with a diagnosis on board, the Jones family find themselves once again in a time of crisis. Where James’s self harm and suicidal tendencies, his violence, aggression and extreme mood swings are wreaking their chaos on the family as a whole. It’s devastating to see their child experience this; to watch him helpless in the grip of the disorder that causes such extreme anxiety and stress. He is convinced that he is fat, ugly, worthless and useless; that he has no redeeming qualities and is stupid, unteachable, unreachable.

He is none of these things but cannot see other. He cannot find a way through. In his darker moments, he really does want to end it all and terrifyingly in the moment is unable to see any other way out. His parents want to simultaneously hug him so tight they will never let go and yet shake him to wake up and fight. They also feel guilt that they sometimes intensely dislike the havoc that is being wreaked on them, their other children, their home. It was bad enough when unidentified numbers only meant calls from hospitals or consultants, now  seeing  No Caller ID flash up on their mobiles often heralds a phone call from school detailing that James has gone awol, insulted a teacher or got into a fight.

The Jones’s were forced to admit their son to hospital recently following a profound escalation in his risky behaviours and concerns that they were unable to keep him or their other children safe. Multiple agencies are involved in trying to support the Jones family and CAMHS wanted to help, they really did. But the family had presented at 10am on a Thursday night to A&E and CAMHS work 9-5 Monday to Friday.

At the mercy of numerous professionals the Jones prepare to keep fighting the good fight. Surely with a diagnosis on board, accessing support will be so much easier than dealing with their other conundrum children who remain undiagnosed? And there’s the rub – government funding and cut backs to mental health services in the UK are well known and so the whole process is just as daunting, just as lacking in cohesion and perhaps even just as time consuming from a co-ordinated care approach?

Mental health services for children and young people in England were cut by £35million last year, whilst mental health beds have been reduced by 8 per cent since 2010. (Source: The Independent, January 2016)

34 out of 51 (Two-thirds) of local authorities in England have reduced their CAMHS budget since 2010. One council reported to YoungMinds a drop of 41% in their CAMHS budget from 2010. 

YoungMinds are the UK’s leading charity committed to improving the emotional wellbeing and mental health of children and young people. They campaign, research and influence policy and practice as well as providing expert knowledge to professionals, parents and young people. For more info:  http://www.youngminds.org.uk/about/what_we_do

So where are the Jones family now? Despite James stating quite clearly that he fully intended to try and take his life again, that he could see no reason for living, Mrs James was told that the paediatric ward was not the right place for him, that there were no inpatient beds unless to quote “he was dying of an eating disorder or in the hold of a psychotic episode”.

School have been crying out for more advice, more planning, more assistance going forward. They too have to examine the purse strings, magic up funds and resources to keep James safe and in statutory education until the lengthy process of an Education & Health Care plan, which there are no guarantee James will qualify for, have been decided.

The Children’s Prevention Team want to help but they need more information from CAMHS who need more information from school who need more information from CAMHS who need input from Children’s Services and Social Services. And then there’s the paperwork. This family in time of dire need and desperate help: well they can’t get that till the paperworks done so round and round it goes. It would almost be funny if it wasn’t so serious. Will the Jones family story end with “and they all lived happily ever after?” I really don’t know….